Milk Volume Outcomes in Pump-Dependent Mothers of Critically Ill Infants.

The study used convenience sampling from a single NICU and was retrospective, so it cannot prove that gestational age caused the milk volume differences. Milk production was measured only during the first seven days after delivery, so it says nothing about supply after the first week. Seven mothers were excluded from the secretory activation analysis because time to onset of copious milk production was missing. Seven mothers did not achieve copious milk production within seven days, and their time was recorded as 168 hours. Milk production varied widely among individual mothers, and the statistical model corrected for this variability. Breastfeeding attempts and expression sessions were not significantly different between groups, but the early preterm group had fewer breastfeeding attempts, more expression sessions, and the shortest time to first expression, which may have affected results. The amount of milk consumed during breastfeeding was not measured because test weighing was not standard care at the hospital. Factors such as hand expression and intended length of lactation were not collected. This was an exploratory study of retrospective data collected four years ago, so prospective studies are needed.

Dr. Parker is a section editor for the journal and the coauthor and mentor to the primary author, but he was not involved in editorial review or the decision to publish. The other authors have no conflicts of interest.

Do not treat gestational age as a reliable predictor of adequate milk supply. The study followed mothers for only seven days, was observational, and found delayed copious milk production in all groups.